When you picture a future of government-run health care and the complete defeat of the pro-life movement, this is what it looks like - the state decides when it is in your best interests to die:

The nine-month-old, known as "Baby OT", had a rare metabolic disorder and had brain damage and respiratory failure.

His parents had appealed against a ruling at London's High Court that it was in the boy's best interests to withdraw "life-sustaining treatment".

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Doctors treating him had said the boy's life was intolerable and his disability was such that his life had little purpose.

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Lord Justice Ward was told the couple had decided to wait outside the courtroom while the ruling was given as they could not face hearing the decision.

A spokeswoman for the BMA said: "Cases like this are very distressing and we have every empathy with the parents, but when the parents and the clinical team don't agree on the treatment for the child in question, the only way forward is to go to the courts and for the courts to decide on what is in the best interests of the child, which is paramount."

As long as the "future of government-run health care" is centered on universal insurance coverage as opposed to the British-style system, we don't have to be worried about that scenario.

Of course, I doubt we can afford universal coverage, whether it's desirable or not, given our current levels of debt.

Posted by: MVH at
March 21, 2009 9:53 PM

If the government provides the funding for universal insurance (Why should a little thing like massive debt stop them? Just print money.), then the pressure to ration care to cut costs will be irresistible. We will have the British-Canadian system, intended or not.

And it happens even if a patient is insured and no hospital is willing to take them, regardless if the patient still has insurance funding available - many are not willing to commit the resources even though they may be able to profit. A couple of states have various futility laws - I think Idaho is in the process of putting one in now.
And various hospitals (private and public) have their own standards of futility care, shielded by ethics laws. I don't need to envision the future - it's already here. If you've got an elderly or sick relative, call your/their local hospitals to find out if they have futility standards. It's a bit eye opening.

Posted by: Dave at
March 21, 2009 10:52 PM

Meh, my last comment got eaten by the spam filter. Sorry about that. One more link about private hospitals and futility care.

If these parents were in the US, and had no health care, would the child receive treatment in the first place ?

Posted by: Jerry at
March 21, 2009 11:29 PM

If this had happened in the US to parents without health insurance they probably would still be given the option to seek some how, some way of continuing care for their child and not have had their child's life ended against the wishes, on the order of a group of doctors who are unnamed by court-order. These parents were put into the position where the doctors didn't agree with their choice to keep their child alive, and were able to get a judge to agree that parents shouldn't be able to choose to keep their child alive.

You argue that "the pressure to ration care to cut costs will be irresistible. We will have the British-Canadian system, intended or not"

How can the British-Canadian system be the result?? The government wouldn't be "rationing care" - it wouldn't run the hospitals, doctors or physicians, so it couldn't decide what services to provide or not provide to patients.

Now the government *would* be able to decide what to offer under its coverage, but that doesn't stop the patient from seeking care that isn't covered. The patient could pay out-of-pocket, or more likely, purchase private insurance for the kind of medical risks that the government does not cover.

The biggest worry I have with the idea is the cost. The advances continually being made in medical technology are critical to better care, but they are expensive. Even a very bare bones government health insurance policy could become very expensive to fund as time passes simply because of the cost of these advances.

Posted by: MVH at
March 22, 2009 11:14 AM

Given that Obama proposes to offer all Americans the same plan that members of Congress receive, it would be interesting to see how the cost of providing that coverage has increased over time. I'm assuming that the number of people covered under that plan has remained relatively stable over time, and you would need to look at it over a substantial number of years to make sure you get a large enough sample.

Then you'd be able to tell how much it has increased incrementally, and then project that incremental increase to all Americans. You could look at how much it would cost to fully subsidize it and partially subsidize it over time. I have a strong feeling that even partially subsidizing it for all Americans would be a pretty big dollar amount. Has that kind of study been done?

Posted by: MVH at
March 22, 2009 11:28 AM

SFC B - if my comment gets restored, you'll see a few links on futility care.

In the US there are states, and private hospitals, where a board can decide to stop providing care. Regardless of your decision or money available, or the wishes of next of kin. Then, you have a limited amount of time to find a transfer to another hospital, which often will go lacking.
There are private hospitals in Britain where, if this man was rich enough, he likely could have gotten his child into with a transfer. It does not mean the new hospital would have made a different decision than the original.

Posted by: Dave at
March 22, 2009 5:24 PM

Dave is right about UK private hospitals, many people have high quality private insurance, at a fraction of the price of US medical insurance.

Although I wonder whether at some point there would have been a similar dispute between the parents and the insurers.

Posted by: snag at
March 22, 2009 7:42 PM

The most revolting thing about this story—and others like it—is this phrase: "Doctors treating him had said the boy's life was intolerable…" Yeah, it's always for the good of the child, isn't it?

If this can be adapted to murderers, we can probably bring the death penalty to a new height of popularity. "Poor miserable felon—his life must be intolerable to him. Hand me that syringe, would you?"

The state can always determine when it is in their best interest for you to die. Draft Boards, Military, police looking the other way, capital punishment, failing to do AIDS research, failure to provide adequate health care for those without private insurance...there are many ways this happens daily...